Quick Answer
Mental illness can often worsen with age due to biological, psychological, and social factors. However, this is not always the case, as proper treatment and healthy lifestyle habits can help manage symptoms.
As we grow older, our bodies and minds go through many changes. For those living with mental illness, the aging process can present unique challenges. Some mental health conditions do tend to worsen with age, while others may improve or stay the same.[1]
There are a few key reasons why mental illness can progress as we get older:
Biological factors
– Brain changes: Advancing age often brings changes in brain chemistry and structure. Declining cognition can exacerbate certain mental illnesses.[2]
– Physical illness: Chronic medical conditions become more common with age. These illnesses and their treatments can negatively impact mental health.[3]
– Medications: Adverse side effects and interactions between psychiatric meds and those for physical conditions can occur.[4]
Psychological factors
– Cognitive decline: Decreased working memory, attention span and problem-solving ability may worsen symptoms.[5]
– Personality changes: With age, some people become more anxious, tired or irritable, which can influence mental health.[6]
– Coping abilities: Older adults may have more difficulty managing stress, regulating emotions and bouncing back from setbacks.[7]
Social factors
– Isolation: Physical limitations, lack of mobility and the death of loved ones can lead to loneliness in older age.[8]
– Major life changes: Transitions like retirement, relocation and becoming a caregiver can be emotionally taxing.[9]
– Financial stress: Fixed incomes make it difficult to afford medical care, including mental health services.[10]
– Ageism: Negative stereotypes, prejudice and reduced independence can lower self-esteem.[11]
So in many cases, the natural aging process and its associated pressures do make symptoms of conditions like anxiety, depression and bipolar disorder worse over time. However, a person’s overall health, lifestyle and access to proper treatment are important factors as well. With the right support, many elders living with mental illness can thrive just as well as when they were younger.
How Different Mental Illnesses Progress with Age
The progression of each type of mental illness in aging varies. Let’s take a closer look at some common conditions.
Anxiety disorders
Anxiety disorders like generalized anxiety disorder (GAD), panic disorder, social anxiety and phobias affect over 15% of older adults.[12] Anxiety symptoms often worsen with age due to factors like:
– Physical illness provoking more worry[13]
– Loss of independence increasing anxiety[14]
– Age-related brain changes affecting fear regulation[15]
Late-life anxiety is linked to higher rates of chronic conditions, mobility issues, isolation and suicide risk.[16] Proper treatment is key to managing anxiety in older populations.
Depression
While depression can affect folks at any age, prevalence increases with age. Around 5-10% of older adults have major depressive disorder.[17] Reasons depression may worsen over time include:
– Loss of purpose after retirement or widowhood[18]
– Declining physical and cognitive health[19]
– Social isolation and loneliness[20]
– Vascular disease damaging areas involved in mood regulation[21]
Late-life depression has been associated with higher dementia risk and suicide rates.[22] But psychotherapy, medication and social support can help elders experiencing depression.
Bipolar disorder
The peak onset of bipolar disorder is actually in the late teens to mid 20s.[23] As people with bipolar age, research suggests:
– Manic episodes may decrease[24]
– Depressive episodes stay the same or increase slightly[25]
– Severity of mood swings may stabilize[26]
So some elders with bipolar find that their condition improves over time. However, medical illness, stress and cognitive changes can still provoke mood episodes. Supportive therapy and mood stabilizing meds help manage bipolar disorder in later life.
Schizophrenia
Schizophrenia affects about 1.2% of older adults.[27] In many cases, schizophrenia symptoms like hallucinations, delusions and disorganized thinking may improve with age.[28] Reasons include:
– Changes in brain chemistry over time[29]
– Developing better coping strategies[30]
However, conditions like dementia and adverse medication effects can cause symptom relapses. Ongoing antipsychotic meds and psychosocial support are important for managing schizophrenia in older populations.
Personality disorders
Personality disorders like borderline, narcissistic, and antisocial PD represent rigid, unhealthy patterns of thinking and behaving. Research on how these disorders progress with age shows:
– Symptoms may gradually improve over time[31]
– However, core personality traits usually persist throughout life[32]
For example, the chaotic behaviors seen in borderline PD often stabilize by middle age. But chronic feelings of emptiness and difficulties with relationships can continue. Therapy helps older adults with personality disorders improve coping and relationships.
Can Mental Illness Get Better with Age?
While many mental illnesses do indeed worsen with advancing age, they can sometimes improve as well. Let’s explore when and why this happens.
More life experience
As people grow older, they tend to develop better coping strategies, perspective and emotional regulation. Elders have the benefit of years of accumulated life experience and wisdom to draw upon. With time, those with mental illness can learn to manage symptoms, handle stressors and ask for help.
Treatment and healthy living
Good physical health, an active social life, cognitive stimulation and therapy can all prevent worsening of mental illness in older age. Making positive lifestyle choices and getting proper medical care provides stability. Some find that committing to treatment and wellness helps improve their condition.
Brain and hormonal changes
For some mental illnesses like bipolar disorder and schizophrenia, changing hormone levels and brain chemistry over time may naturally dampen symptoms. However, medication and psychosocial treatment are still necessary.
Less stress and responsibility
Retirement brings leisure time and freedom from workplace stress. With grown children and more financial stability, older adults may worry less. Less work and family responsibility can translate to improved mental health for some.
However, it is important for elders to stay active and involved to fend off boredom and isolation. Overall though, less exposure to stressful situations in later life may ease certain mental health disorders.
Tips for Managing Mental Illness in Older Age
While aging certainly presents challenges, there are many effective ways to take care of your mental health as you get older. Here are some key tips:
Stay socially engaged
Make an effort to regularly connect face-to-face with family, friends, and peers. Join communities like activity groups, book clubs, or senior centers. Feeling involved provides purpose and belonging.
Exercise and eat well
Be physically active as you are able. Follow a nutritious diet focusing on whole foods. Staying active and fueling your body properly supports mental health.
Practice stress management
Try techniques like mindfulness, deep breathing, meditation, yoga, or Tai Chi to relax and center yourself. Set boundaries and learn to say no to maintain balance.
Get good medical care
See your doctor and take medications as prescribed. Have conditions like thyroid disease, diabetes and vitamin deficiencies checked. Managing physical health aids mental health.
Consider psychotherapy
Cognitive-behavioral therapy (CBT) helps change negative thought patterns. Dialectical behavior therapy (DBT) teaches coping strategies. Such talk therapy can benefit your mental health.
Stay cognitively stimulated
Challenge your brain daily by doing puzzles, reading, writing, playing games and learning new skills. Keeping the mind active may help delay cognitive decline.
Prioritizing healthy aging of both mind and body can help keep many mental illnesses in check. But be sure to seek professional help from your doctor or mental health provider if you have any concerns.
The Importance of Ongoing Treatment
While some mental health conditions may improve with age, treatment is still crucial. Stopping medications and therapy abruptly often leads to worsening symptoms, even for those who seem to be doing better. Some key reasons to continue treatment include:
Preventing relapse
Ongoing care helps keep mental illness in remission and avoid recurrent episodes or symptom flare ups. Maintaining stability is important.
Managing new issues
Later life brings new stressors that can trigger mental illness. Treatment provides coping skills and support through age-related challenges.
Reducing suicide risk
Older men have the highest suicide rate of any group. Staying engaged in care lowers risks associated with mental disorders.
Transitioning care
As you age, your care providers and services may change. Your team can best guide treatment adjustments and ensure continuity.
While past issues may improve, treatment teaches lifelong healthy coping. Work closely with your mental health providers to find the best path forward as you age.
When to Seek Help
Many older adults notice their mental health deteriorating but don’t know where to turn. If you see any of the following changes, it is important to seek support:
– Feelings of sadness or anxiety persisting over 2 weeks
– Losing interest in normal activities
– Thoughts of suicide
– Feeling excessively worried, angry or lonely
– Sleep disturbances
– Changes in appetite and weight
– Decline in cognition or functioning
– Hallucinations or strange beliefs
– Alcohol or medication misuse
Don’t assume these issues are just a normal part of aging. Start by talking to your primary doctor. They can check for underlying causes and refer you to a psychiatrist, therapist, or other mental health professional as needed.
With the help of your care team, you can get an accurate diagnosis, start appropriate treatment, and take steps to improve your mental well-being, regardless of age.
Conclusion
Mental illness can progress as we grow older due to biological, psychological and social factors associated with aging. However, proper treatment and healthy living can help manage symptoms.
While some conditions like anxiety and depression often worsen over time, others like bipolar and schizophrenia may improve in later life. Staying socially engaged, managing stress, exercising, eating well and utilizing therapy supports mental health.
Working closely with your doctor and mental health providers allows you to adjust treatment as needed to age successfully. With the right care, it is possible to thrive with mental illness even in your elder years.
